Therapist and Patient. The American Psychoanalyst, 51,1.

Assessing Distance Psychoanalytic Treatment: Perspectives of

Therapist and Patient

Robert M. Gordon

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Now we have the option of delivering psychoanalytic services online to those who otherwise would not have easy access to such services. This new channel of connection is suspect to some psychoanalysts who fear that the Internet filters out too much of the interpersonal quality of the therapeutic relationship, according to a study I did with with Jane Tune and Xiubing Wang in 2016. Certainly, using videoconferencing (VCON) technology has its problems with connections, privacy and sense of physical presence. But are these issues analyzable or not? Is the online treatment effective and worthwhile? Assessing this is difficult with complex variables and issues of methodological validity.

Laboratory research that could isolate and manipulate the variables would present ethical and external validity concerns. We believe that surveying the experiences of highly educated deliverers and end-users of psychoanalytic treatment would be a useful methodology. The China American Psychoanalytic Alliance (CAPA) therapists and program graduates who were patients were a population of convenience, which allowed us to study this complex issue. The CAPA graduates/patients are intelligent and informed consumers of psychoanalytic training and treatment. They are a population that can offer insightful feedback about their treatment during their training.

In 2015, we studied the online surveys of 94 therapists in CAPA who treated the Chinese students via videoconferencing and in 2017 we studied the surveys of 97 graduates of CAPA who were their patients.

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The survey results showed that the therapists rated the overall effectiveness of the treatment over the Internet as only slightly less effective than in-person treatment.

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The graduates/patients had a median of three average days a week of treatment. The survey results of the graduates/patients showed they highly rated the effectiveness of their own online psychoanalytic therapy (median = 5.0 (0= not at all effective, 6= extremely effective). Sixty-nine percent rated their online treatment in the high to very high range (ratings 5-6). Graduates/patients felt the therapist variables (warmth, wisdom, empathy and skillfulness) were much more important in the effectiveness of their treatment than whether the treatment was in-person or with VCON. These graduates/patients preferred to experience some issues with online treatment in order to have the opportunity to work with a high quality therapist, according to an assessment by Jing Lan and me this year).

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When looking at the opinions of both therapists and patients, psychoanalytic treatment over VCON represents a valuable treatment delivery option.

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These studies were approved by the Institutional Review Board of the Washington Center of Psychoanalysis. For copies of the research manuscripts, contact me at rmgordonphd@gmail.com.